Goldberger Jeffrey J
Northwestern University Feinberg School of Medicine, Division of Cardiology, Chicago, Illinois 60611, USA.
Heart Rhythm. 2009 Mar;6(3 Suppl):S2-7. doi: 10.1016/j.hrthm.2008.11.007. Epub 2008 Nov 8.
Identifying risk factors to predict sudden cardiac death (SCD) is an important area of investigation. Current techniques are limited. Several issues result in limitations in the design and interpretation of studies focused on risk stratification to identify patients at risk for fatal ventricular tachyarrhythmias. These include the uncertainty in the identification of SCD, the plurality of causes of SCD, and the complexity of the pathophysiology of the development of fatal ventricular tachyarrhythmias. Understanding the ways in which evidence is accumulated to identify a risk factor for SCD and the strength of evidence that is required for clinical decision-making, as opposed to identifying associations, are critical steps to advancing the field.
识别预测心脏性猝死(SCD)的危险因素是一个重要的研究领域。目前的技术存在局限性。有几个问题导致了专注于风险分层以识别致命性室性心律失常风险患者的研究在设计和解释方面受到限制。这些问题包括SCD识别的不确定性、SCD病因的多样性以及致命性室性心律失常发生的病理生理学复杂性。理解积累证据以识别SCD危险因素的方式以及临床决策所需的证据强度,而非仅仅识别关联,是推动该领域发展的关键步骤。